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CPT code 11404: Skin excision, trunk or extremity, 3.1–4 cm2026 Medicare rate & RVUs in San Francisco, CA

Removal of a benign skin lesion on the trunk, arm, or leg when the lesion and required margins measure 3.1 to 4 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality16.2K Medicare services in 2024

In San Francisco, CA, Medicare pays $292.38 for 11404 in the office and $180.77 when it’s performed in a hospital or facility.

$292.38Office (non-facility)
$180.77Hospital or facility
+26.5%vs the national office rate ($231.13)

Check a contract rate as a % of Medicare · 11404 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 11404 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in San Francisco, CA
  2. What 11404 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 11404 covers

This service involves removing a benign skin lesion from the trunk or an extremity, such as a benign-appearing nevus or epidermal cyst. Dermatologists, primary care clinicians, and surgeons commonly perform it in an office or outpatient procedure setting. The code selection is based on the lesion’s greatest diameter plus the narrowest margins needed for removal, measured before excision—not the length of the resulting wound.

Document the lesion’s site and dimensions, the margins included in the excision, and the procedure performed. Routine simple closure is included; a separately reportable intermediate or complex repair may be coded when performed and documented. Related postoperative visits are included in the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How San Francisco, CA compares for 11404

Across 109 of 109 payment localities, the office rate for 11404 runs from $204.11 in Arkansas to $299.56 in San Benito County, CA. San Francisco, CA pays $292.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

11404 in San Francisco, CA vs other payment areas
  1. San Francisco, CA · this page$292.38
  2. Bakersfield, CA · California$242.17−$50.21
  3. Chico, CA · California$241.15−$51.23
  4. El Centro, CA · California$241.21−$51.17
  5. Fresno, CA · California$241.15−$51.23
  6. Hanford, CA · California$241.15−$51.23
  7. Los Angeles, CA · California$257.42−$34.96

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

11404 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$241.15$154.39
Merced, CACalifornia$241.15$154.39
Modesto, CACalifornia$241.15$154.39
Napa, CACalifornia$277.35$173.02
Oxnard, CACalifornia$255.88$162.32
Redding, CACalifornia$241.15$154.39
Rest of CaliforniaCalifornia$241.15$154.39
Riverside, CACalifornia$245.03$158.27

11404 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$204.11

$270.36

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
11404 office rate range by state
State / territoryOffice rate rangeLocalities
AK$269.911
AL$207.131
AR$204.111
AZ$224.741
CA$241.15–$299.5629
CO$238.951
CT$246.611
DC$262.961
DE$228.461
FL$230.57–$255.683
GA$217.21–$236.162
GU$246.661
HI$246.661
IA$211.111
ID$212.771
IL$224.83–$247.944
IN$213.981
KS$210.741
KY$213.431
LA$213.34–$223.902
MA$237.76–$261.792
MD$232.64–$262.963
ME$214.56–$225.342
MI$219.61–$234.122
MN$227.031
MO$210.08–$223.943
MS$207.101
MT$231.111
NC$216.721
ND$223.991
NE$212.081
NH$235.791
NJ$248.88–$260.342
NM$221.081
NV$229.281
NY$220.05–$274.255
OH$218.151
OK$212.371
OR$226.96–$245.842
PA$218.15–$240.862
PR$232.611
RI$236.101
SC$217.911
SD$223.151
TN$211.891
TX$216.75–$238.628
UT$220.891
VA$225.04–$262.962
VI$232.611
VT$223.691
WA$237.12–$266.492
WI$216.501
WV$216.631
WY$228.011

See 11404 in every payment locality

How the 11404 rate is calculated

Each of 11404’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 11404

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense4.50

4.50 RVUs× 1.000 GPCI

Malpractice0.36

0.36 RVUs× 1.000 GPCI

Adjusted RVUs

6.9200

Conversion factor

$33.4009

Medicare rate

$231.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact San Francisco, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,313

Code
11404
Physician work
2.06
Practice expense
4.50
Malpractice
0.36

GPCI2026.csv

24

Locality
San Francisco, CA
Physician work
1.095
Practice expense
1.410
Malpractice
0.425
Office calculation for 11404 in San Francisco, CA
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0952.2557
Practice expense4.50× 1.4106.3450
Malpractice0.36× 0.4250.1530
Total RVUs8.7537
Conversion factor× 33.4009

Office rate, San Francisco, CA$292.38

Office: (2.06 × 1.095 + 4.5 × 1.41 + 0.36 × 0.425) × $33.4009 = $292.38

Facility: (2.06 × 1.095 + 2.13 × 1.41 + 0.36 × 0.425) × $33.4009 = $180.77

Open 11404 in the RVU calculator

Payment rules and modifiers for 11404

11404 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 11404

Skin excision, trunk or extremity, 3.1–4 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 11404

Skin excision, trunk or extremity, 3.1–4 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

11404 without 51 · national office

$231.13

Skin excision, trunk or extremity, 3.1–4 cm

11404-51 · Second procedure: 50%

$115.57

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 11404

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 11404
CodeHow it relatesOffice range, San Francisco, CA
Same family
11403Benign lesion excision, trunk or limb, 2.1–3 cmSame trunk and extremity sites, for the smaller adjacent excision-size range.$254.57
11406Skin lesion excision, trunk or extremity, over 4 cmSame trunk and extremity sites, for lesions with excision diameter greater than 4 cm.$413.34
11424Lesion excision, scalp, neck, hands, feet, genitaliaSame size range for lesions on the hand, foot, neck, or genital area.$306.16
11444Skin excision, face, 3.1–4 cmSame size range for benign lesions excised from the face.$359.56
Often billed with
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesMay be separately reported for a qualifying intermediate repair of the trunk or extremity.$388.48

How 11404 has changed in San Francisco, CA

11404 · Office / nonfacility

$292.38

Effective 2026-10-01

The base rate is $15.57 higher than on 2025-10-01, moving from $276.81 to $292.38 (5.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $276.81changed to$292.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 4.30 changed to 4.50
    • Work GPCI 1.088 changed to 1.095
    • Practice expense GPCI 1.419 changed to 1.410
    • Malpractice GPCI 0.445 changed to 0.425

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $285.18changed to$276.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.31 changed to 4.30
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $280.53changed to$285.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $282.01changed to$280.53

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.28 changed to 4.31
    • Work GPCI 1.082 changed to 1.088
    • Practice expense GPCI 1.374 changed to 1.419
    • Malpractice GPCI 0.452 changed to 0.445

  5. January 1, 2023

    RVU23A

    $279.49changed to$282.01

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.25 changed to 4.28
    • Malpractice RVU 0.34 changed to 0.35
    • Work GPCI 1.077 changed to 1.082
    • Practice expense GPCI 1.329 changed to 1.374
    • Malpractice GPCI 0.458 changed to 0.452

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $279.96changed to$279.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.21 changed to 4.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $273.31changed to$279.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.88 changed to 4.21
    • Malpractice RVU 0.35 changed to 0.34
    • Work GPCI 1.076 changed to 1.077
    • Practice expense GPCI 1.327 changed to 1.329
    • Malpractice GPCI 0.440 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $267.69changed to$273.31

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.77 changed to 3.88
    • Malpractice RVU 0.39 changed to 0.35
    • Work GPCI 1.075 changed to 1.076
    • Practice expense GPCI 1.325 changed to 1.327
    • Malpractice GPCI 0.421 changed to 0.440

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $265.81changed to$267.69

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.74 changed to 3.77
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $267.41changed to$265.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.69 changed to 3.74
    • Malpractice RVU 0.39 changed to 0.38
    • Work GPCI 1.077 changed to 1.075
    • Practice expense GPCI 1.357 changed to 1.325
    • Malpractice GPCI 0.439 changed to 0.421

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $270.28changed to$267.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.67 changed to 3.69
    • Work GPCI 1.079 changed to 1.077
    • Practice expense GPCI 1.388 changed to 1.357
    • Malpractice GPCI 0.457 changed to 0.439

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $270.43changed to$270.28

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.66 changed to 3.67
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $269.08changed to$270.43

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $264.63changed to$269.08

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.60 changed to 3.66
    • Malpractice RVU 0.35 changed to 0.37
    • Work GPCI 1.076 changed to 1.079
    • Practice expense GPCI 1.374 changed to 1.388
    • Malpractice GPCI 0.487 changed to 0.457

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $270.39changed to$264.63

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.04 changed to 3.60
    • Malpractice RVU 0.37 changed to 0.35
    • Work GPCI 1.072 changed to 1.076
    • Practice expense GPCI 1.360 changed to 1.374
    • Malpractice GPCI 0.516 changed to 0.487

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$270.39

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$292.38$180.77RVU26D
2026-07-01$292.38$180.77RVU26C
2026-04-01$292.38$180.77RVU26B
2026-01-01$292.38$180.77RVU26A
2025-10-01$276.81$196.94RVU25D
2025-07-01$276.81$196.94RVU25C
2025-04-01$276.81$196.94RVU25B
2025-01-01$276.81$196.94RVU25A
2024-10-01$285.18$200.16RVU24D
2024-07-01$285.18$200.16RVU24C
2024-04-01$285.18$200.16RVU24B
2024-03-09$285.18$200.16RVU24AR
2024-01-01$280.53$196.89RVU24A
2023-10-01$282.01$196.80RVU23D
2023-07-01$282.01$196.80RVU23C
2023-04-01$282.01$196.80RVU23B
2023-01-01$282.01$196.80RVU23A
2022-10-01$279.49$193.03RVU22D
2022-07-01$279.49$193.03RVU22C
2022-04-01$279.49$193.03RVU22B
2022-01-01$279.49$193.03RVU22A
2021-10-01$279.96$191.85RVU21D
2021-07-01$279.96$191.85RVU21C
2021-04-01$279.96$191.85RVU21B
2021-01-01$279.96$191.85RVU21A
2020-10-01$273.31$192.85RVU20D
2020-07-01$273.31$192.85RVU20C
2020-04-01$273.31$192.85RVU20B
2020-01-01$273.31$192.85RVU20A
2019-10-01$267.69$191.28RVU19D
2019-07-01$267.69$191.28RVU19C
2019-04-01$267.69$191.28RVU19B
2019-01-01$267.69$191.28RVU19A
2018-10-01$265.81$190.92RVU18D
2018-07-01$265.81$190.92RVU18C
2018-04-01$265.81$190.92RVU18B
2018-01-01$265.81$190.92RVU18AR1
2017-10-01$267.41$192.89RVU17D
2017-07-01$267.41$192.89RVU17C
2017-04-01$267.41$192.89RVU17B
2017-01-01$267.41$192.89RVU17A
2016-10-01$270.28$194.74RVU16D
2016-07-01$270.28$194.74RVU16C
2016-04-01$270.28$194.74RVU16B
2016-01-01$270.28$194.74RVU16A
2015-10-01$270.43$195.62RVU15D
2015-07-01$270.43$195.62RVU15C
2015-04-01$269.08$194.64RVU15B
2015-01-01$269.08$194.64RVU15A
2014-10-01$264.63$191.29RVU14D
2014-07-01$264.63$191.29RVU14C
2014-04-01$264.63$191.29RVU14B
2014-01-01$264.63$191.29RVU14A
2013-10-01$270.39$192.65RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 11404 for an earlier date of service

Where the San Francisco, CA rate applies

San Francisco, CA is a Medicare payment area, not a city. Our Census mapping connects it to 107 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Alameda
  • Berkeley
  • Oakland
  • San Francisco
  • San Mateo
  • Acalanes Ridge
  • Alamo
  • Albany

Browse all communities in California

11404 billing questions

How do I distinguish 11404 from 11403 or 11406?

Measure the lesion together with the margins required for excision. Use 11404 when that measurement is 3.1–4 cm; 11403 is for the smaller adjacent size range, and 11406 is for a measurement greater than 4 cm.

Can I report 11404 for a lesion on the hand or face?

No. This code is for the trunk and extremities other than the anatomic areas assigned to separate code series. Hand, foot, neck, and genital sites use the 11420–11426 series; facial sites use the 11440–11446 series.

Is wound closure included?

Simple closure is included in the excision. A separately reportable intermediate or complex repair may be coded when that repair is actually performed and documented.

Does the 10-day global period include postoperative visits?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can modifier 50 be used for lesions removed on both sides?

No. The bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 11404PPRRVU2026_Oct_nonQPP.csv, line 1,313 (RVU26D)
Geographic factors for San Francisco, CAGPCI2026.csv, line 24 (RVU26D)

Open CMS sourceHow we calculate rates

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